Individual
MELISSA MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 410-4992
Mailing address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 410-4992
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
6301009289
MI
103TB0200X
Cognitive & Behavioral Psychologist
Primary
6361003906
MI
Other
Enumeration date
12/21/2009
Last updated
11/09/2021
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